"The NHS will last as long as there are folk left with the faith to fight for it"Aneurin Bevan

Tuesday, 9 November 2010

PCT Functions

When the NHS White Paper was first published and announced that PCTs were going to be abolished (incidentally, against what the Coalition Agreement said would happen, but as we all know that piece of paper was a sop to LibDem party members, it was never intended to be actual policy) many people said "huh? who are they and what do they do?".

So the Department of Health and the NHS Confederation produced a document that listed the responsibilities of PCTs. This list came to 211 items and it took 14 pages just to list them. This may sound like bureaucracy, but when you look closer you see that these responsibilities include making sure that money is spent in a cost-effective way, that healthcare is equitable, that strategic planning is done to ensure that facilities are available for expected population changes.

Now I am sure some right-whingers will complain about all of this, but the country is not a majority of ignorant right-whiners, the rest of us want to make sure that healthcare is equitable, that steps are taken to make sure that everyone gets equal access regardless of their race, sex, sexuality or disability.

Many commentators have pointed out that GPs do not have the skills to provide all of this, and hence they will have to employ former PCT commissioners. Lansley see the PCT commissioners as the problem, not the solution. So how does he make sure that GPs do not have to emply PCT commissioners? Easy, get rid of the PCT responsibilities.

Dr James Kingsland, DoH national clinical director for practice-based commissioning in England, said much of a 283-point list compiled by the DoH and the NHS Confederation PCT Network was unnecessary. ‘This is what PCTs used to do. They are being abolished, and their functions are gone,’ he said. ‘We have to rewrite this list and it has to be radically different.’

Since much of the list is about making healthcare access equitable, and about keeping the NHS cost-effective and improving performance, it seems bizarre that the Department of Health will want to abolish most of the responsibilities.

Quoting PCT Network director David Stout:

‘Work was being done to ‘downsize’ the list of functions but none would be easy to abolish, he said. ‘I suspect it will be quite difficult to do as just because they are less important it doesn’t mean they just don’t need to happen,’ Mr Stout said.